Wisdom Teeth

Why Do Some People have a Fourth Molar?

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In the past an article titled What to Do about the Fourth Molar: Similar Management Strategies as the Third Molar aka Wisdom Tooth? discussed the fourth molar which is an additional tooth beyond the wisdom tooth or third molar that some people have. In this article some images of the fourth molar were provided along with some discussion of management strategies. However, no real discussion was made surrounding some of the theories regarding the fourth molar. In an article titled “Presence of the fourth molar. Literature review” by Vázquez Mosquerira et al. appearing in Revista Odontológica Mexicana, (vol. 22, no. 2 April-June 2018, pp. 103-117) some discussion is made surrounding some of the theories of the existence of the fourth molar along with many X-rays of fourth molars. In the article the authors call fourth molars, distomolars. The authors seem … Read more

Infected Wisdom Tooth Leads to Coma In Young Woman

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As has been covered before on this site, wisdom teeth extraction can lead to complications that can be life-long and lasting. On the other hand keeping wisdom teeth and not having them removed can also lead to risks and life-long problems. A recent case of this occurred in a woman who was 23 years old at the time she developed problems. The woman developed a rash and flu-like symptoms. A few days after this her tongue and throat began to swell and this blocked her airways. She was then taken to the emergency room at a hospital where doctors began to investigate. There her blood pressure dropped rapidly and doctors put her in a coma for nine days to try to determine what was going on. After several tests the doctors determined the woman was suffering from Ludwig’s angina which … Read more

Differences Among Classifying Wisdom Teeth using Panoramic X-rays and Cone-Beam Computed Tomography

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An interesting article titled “Is Panoramic Imaging Equivalent to Cone-Beam Computed Tomography for Classifying Impacted Lower Third Molars?” appears in the 2019 edition of the Journal of Oral and Maxillofacial Surgery written by Brasil et al. The article explorers if panoramic radiography is able to give similar results as cone-beam computed tomography (CBCT) for the degree of lower wisdom teeth impaction and when using panoramic radiography if the external oblique ridge is a reliable indicator for the degree of lower wisdom teeth impaction. In the article the authors discuss the Pell and Gregory classification which is used to classify the position of a wisdom tooth and can be used to potentially assess the risks of various complications. The authors state how wisdom teeth are usually evaluated using panoramic x-rays but this technique is susceptible to image overlap, magnification, and distortion, … Read more

Reducing Opioids in Oral and Maxillofacial Surgery

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An interesting article titled “Opioid Prescribing Can Be Reduced in Oral and Maxillofacial Surgery Practice,” written by Tatch appears in the 2019 edition of the Journal of Oral and Maxillofacial Surgery. In the article the author discusses the results of implementing an office protocol for pain management to reduce opioid use in oral and maxillofacial surgery during a three year time period. Results from a similar study were presented previously in a post titled Oral and Maxillofacial Surgeons Current Perspectives on Opioid Prescribing. In the article the author discusses how a risk of opioids is dependence which can develop after just one week of using. The author came up with a 3-year retrospective study to measure changes in opioid use after the introduction of an office protocol which was designed to offer alternatives to pain relief. In the study a … Read more

Osteomyelitis after Wisdom Teeth Removal can Lead to Multiple Reconstructive Surgeries

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Wisdom teeth removal is not without risks and complications such as osteomyelitits can occur. Osteomyelitits is an inflammation and infection of bone cortex and marrow that develops in the jaw. Some symptoms that can occur with osteomyelitits include high body temperature, increased pain, and neck swelling. In some cases emergency treatment is required to prevent death. In a case in 2012, a 24 year old man woman had an upper left and a lower right wisdom tooth extracted by an oral and maxillofacial surgeon. Five days after surgery the woman returned to the oral surgeon’s office where he discoveredmild swelling near the lower right wisdom tooth site, without pus, and a large amount of food debris. He irrigated the area, placed gel foam packing, and gave the woman a prescription for penicillin. Ten days after surgery the woman returned to … Read more